This invention relates to devices and methods for laparoscopic surgery, and more particularly to devices and methods for inserting and removing tacks during laparoscopic surgery.
Laparoscopic surgery, or the effecting of surgical procedures in body cavities through body walls, became feasible with the development of small cross-section viewing and manipulating instruments, and has since been the procedure of choice for a number of particular operative situations. Consequently, there have been developed a significant number of devices that can be inserted into a body cavity for moving, cutting, fastening and cauterizing, among other functions, so that laparoscopic procedures can be carried out quickly, with low trauma and thus with minimal discomfort and recovery time.
A number of different surgical procedures have been developed or are contemplated for use, for example, in the abdominal cavity. Abdominal rectopexy, involving such conditions as a prolapsed uterus, prolapsed vagina or prolapsed rectum, has been treated using this approach. The abdominal cavity affords not only sufficient volume in which to conduct necessary surgical procedures, while visualizing the site through a camera port or using an endoscope, but also includes usable anchor structures, such as cartilage of the sacrum. Experimental procedures have shown that prolapsed tissue can be manipulated to, and then anchored in, a given position, using a mesh of sterile, inert filaments. For this purpose, however, a laparoscopic tacking instrument is needed that will meet the size and shape constraints imposed on any laparoscopic device. The instrument should further maintain a tack in unexposed position during insertion, provide a seating surface that does not slip when the tack is being driven in, allow verification of the tack position, retain the tack securely so that it cannot become loose within the body cavity, and permit application of the necessary forces for driving the tack into and out of position. Both embedment and disengagement of the tack should be feasible with the same instrument.